Congenital muscular torticollis: the reliability of visual estimation in the assessment of cervical spine active rotation and head tilt by physiotherapists and the impact of clinical experience
- 29 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Pediatrics
- Vol. 179 (11), 1823-1832
- https://doi.org/10.1007/s00431-020-03691-8
Abstract
There is a lack of reliable and valid measurement tools to assess neck function in infants with congenital muscular torticollis, and most physiotherapists use visual estimation, which has not been adequately tested for reliability in this population. We examined the reliability of visual estimation of head tilt and active neck rotation in the upright position, on infants with congenital muscular torticollis by physiotherapists. We recruited 31 infants and 26 physiotherapists. Therapists rated videos of infants’ head position in the frontal plane (tilt) and transverse plane (active rotation) using visual estimation, on two occasions at least one week apart. Overall, inter-rater reliability was good (mean ICC, 0.68 ± 0.20; mean SEM, 5.1° ± 2.1°). Rotation videos had better reliability (mean ICC, 0.79 ± 0.14) than head tilt videos (mean ICC, 0.58 ± 0.20). Intra-rater reliability was excellent (mean ICC, 0.85 ± 0.08). Both head tilt and rotation had excellent reliability (mean ICC, 0.84 ± 0.08 for head tilt and 0.85 ± 0.09 for rotation). There was no correlation between intra-rater reliability and clinical experience. Conclusion Visual estimation had excellent intra-rater reliability in the assessment of neck active rotation and head tilt on infants with congenital muscular torticollis. Visual estimation had acceptable inter-rater reliability in the assessment of neck active rotation but not of head tilt. There was a wide variation in reliability with no correlation between reliability and clinical experience. Assessment tools for head tilt that are more psychometrically robust should be developed. What is Known: • A thorough assessment of infants presenting with torticollis is essential, using assessment tools with robust psychometric properties • Visual estimation is the most commonly used method of assessment of neck function in infants with torticollis What is New: • Visual estimation had excellent intra-rater reliability in the assessment of neck active rotation and head tilt in the upright position in videos of infants and acceptable inter-rater reliability in the assessment of rotation but not of head tilt • Physiotherapists’ clinical experience had minimal relationship with reliabilityKeywords
Funding Information
- Temple Street Foundation, Dublin, Ireland (RPAC 15-02)
This publication has 77 references indexed in Scilit:
- The Cervical Range of Motion as a Factor Affecting Outcome in Patients With Congenital Muscular TorticollisAnnals of Rehabilitation Medicine, 2013
- Prevention and Management of Positional Skull Deformities in InfantsPediatrics, 2011
- Clinical features and outcome of physiotherapy in early presenting congenital muscular torticollis with severe fibrosis on ultrasonography: a prospective studyJournal of Pediatric Surgery, 2011
- Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposedInternational Journal of Nursing Studies, 2011
- A Systematic Review of Reliability and Validity Studies of Methods for Measuring Active andPassive Cervical Range of MotionJournal of Manipulative and Physiological Therapeutics, 2010
- Is visual estimation of passive range of motion in the pediatric lower limb valid and reliableBMC Musculoskeletal Disorders, 2009
- Clinimetric evaluation of active range of motion measures in patients with non-specific neck pain: a systematic reviewEuropean Spine Journal, 2008
- Symptomatic asymmetry in the first six months of life: differential diagnosisEuropean Journal of Pediatrics, 2008
- Reliability: What is it, and how is it measured?Physiotherapy, 2000
- Comparison of Visual Estimation and Goniometry for Assessment of Metacarpophalangeal Joint AnglePhysiotherapy, 1999